Narcolepsy Suddenly Cant Wake Up Again

Narcolepsy is a sleep disorder marked by excessive sleepiness during the solar day or recurring, uncontrollable episodes of slumber during normal waking hours, usually with sudden episodes of musculus weakness (cataplexy). Other symptoms include sleep paralysis, brilliant dreams, and hallucinations while falling comatose or waking up from sleep.

• Testing in a slumber laboratory, with polysomnography and multiple slumber latency testing, is needed to confirm the diagnosis.

• Drugs are used to help proceed people awake and to control other symptoms.

Narcolepsy occurs in virtually i of 2,000 people in the United States, Europe, and Japan. Information technology is equally common amongst men and women.

What causes narcolepsy is unknown. Some people with narcolepsy have a similar grouping of genes, just the cause is not thought to exist genetic. Environmental factors seem to be involved and may trigger the disorder. Some evidence suggests that narcolepsy may exist caused by an autoimmune reaction that destroys nerve cells in a sure expanse of the brain. (An autoimmune reaction Autoimmune Disorders occurs when the immune system attacks the trunk's own tissues.)

People with narcolepsy slumber a lot during the day. As a result, narcolepsy can be disabling and increases the take a chance of motor vehicle and other accidents. Narcolepsy persists throughout life just does non touch on life expectancy.

Narcolepsy reflects, in part, abnormalities in the timing and control of rapid eye move (REM) sleep. Many symptoms resemble what happens during REM sleep. The muscle weakness, sleep paralysis, and hallucinations of narcolepsy resemble the loss of musculus tone, paralysis, and vivid dreaming that occur during REM sleep.

Idiopathic hypersomnia, similar narcolepsy, results in excessive daytime sleepiness. Polysomnography Diagnosis and a multiple sleep latency exam Diagnosis are needed to help make up one's mind which of the ii disorders is causing excessive daytime sleepiness.

Symptoms of narcolepsy usually brainstorm during adolescence or young machismo and persist throughout life.

The main symptoms are

• Severe excessive daytime sleepiness

• Cataplexy (sudden episodes of muscle weakness)

• Hallucinations while falling asleep or waking up

• Slumber paralysis

• Disturbances in nighttime sleep (such equally waking up oft and having bright, frightening dreams)

Only virtually ten% of people with narcolepsy have all the symptoms. Nearly people take only a few. All have excessive daytime sleepiness.

People with narcolepsy take excessive daytime sleepiness, often despite long periods of excessive sleep. Many people are overcome by sudden episodes of uncontrollable slumber that can occur at any time, often without warning (called slumber attacks). Falling asleep can be resisted just temporarily.

People may have many episodes or but a few in a single 24-hour interval. Each usually lasts a few minutes or less just may final hours. People can exist awakened as readily as from normal sleep. They typically feel refreshed when they wake upward even when the sleep episode lasts a few minutes. Even so, they may fall asleep again in a few minutes.

Episodes of falling asleep are well-nigh likely to occur in monotonous situations, as during boring meetings or long periods of highway driving, only may occur while eating, speaking, or writing.

While people are awake during the 24-hour interval, a sudden episode of muscle weakness without loss of consciousness—called cataplexy—may be triggered by a sudden emotional reaction such equally anger, fearfulness, joy, laughter, or surprise. People may become limp, drop something being held, or autumn to the basis. The jaw may droop, facial muscles may twitch, eyes may shut, and the head may nod. Vision may be blurred. People may slur their speech.

These episodes resemble the normal muscle paralysis that occurs during rapid centre movement (REM) sleep and, to a lesser degree, the experience of beingness "weak with laughter."

Cataplexy causes pregnant problems in almost one fifth of people with narcolepsy.

Occasionally, when but falling asleep or immediately after enkindling, people endeavour to movement but cannot. This experience, called sleep paralysis, can exist terrifying. The touch of another person may relieve the paralysis. Otherwise, the paralysis disappears on its ain afterwards several minutes.

Slumber paralysis occurs in about ane fourth of people with narcolepsy. It sometimes occurs in good for you children and, less frequently, in healthy adults.

When only falling asleep or, less often, when awakening, people may clearly encounter images or hear sounds that are not in that location. These extremely bright hallucinations are similar to those of normal dreaming but are more intense. Hallucinations are called

• Hypnagogic when they occur while falling asleep

• Hypnopompic when they occur while awakening

Hypnagogic hallucinations occur in virtually 1 3rd of people with narcolepsy. They are common among healthy children and occasionally occur in healthy adults.

In people with narcolepsy, nighttime sleep may be interrupted periodically past awakenings and vivid, frightening dreams. Equally a result, sleep is unrefreshing, and people may be even sleepier during the day.

People with narcolepsy often have difficulty functioning and concentrating. They are more likely to hurt themselves—for example, if they fall comatose while driving. Narcolepsy tin can crusade stress. Productivity and motivation may subtract, and concentration may exist poor. People may withdraw from others and thus damage personal relationships. Many become depressed.

• Polysomnography

• Multiple sleep latency testing

Doctors doubtable narcolepsy when people with excessive daytime sleepiness accept had episodes of muscle weakness. Notwithstanding, doctors cannot base of operations the diagnosis on symptoms lonely because other disorders can cause some of the aforementioned symptoms. Sleep paralysis and similar hallucinations occasionally occur in otherwise healthy adults, in people who accept been sleep deprived, and in people with sleep apnea or low. These symptoms may besides occur when sure drugs are taken. Therefore, testing in a sleep laboratory is necessary.

Sleep testing in a slumber laboratory consists of

• Polysomnography, done overnight

• Multiple sleep latency testing, washed the next mean solar day

Polysomnography is usually done in a sleep laboratory, which may be located in a hospital, dispensary, hotel room, or other facility that is equipped with a bed, bath, and monitoring equipment. Electrodes are pasted to the scalp and face to record the brain's electric activity (electroencephalography Electroencephalography Diagnostic procedures may be needed to confirm a diagnosis suggested by the medical history and neurologic examination. Electroencephalography (EEG) is a simple, painless procedure in which... read more , or EEG) as well as center movements. Applying these electrodes is painless. The recordings help provide doctors with information about sleep stages. Electrodes are also fastened to other areas of the body to record heart rate (electrocardiography Electrocardiography Electrocardiography (ECG) is a quick, simple, painless process in which the heart'southward electrical impulses are amplified and recorded. This record, the electrocardiogram (also known as an ECG)... read more than , or ECG), muscle action (electromyography Electromyography and Nervus Conduction Studies Diagnostic procedures may be needed to ostend a diagnosis suggested past the medical history and neurologic examination. Electroencephalography (EEG) is a elementary, painless procedure in which... read more than ), and breathing. A painless clip is attached to a finger or an ear to record oxygen levels in the claret. Polysomnography can detect breathing disorders (such as obstructive sleep apnea), seizure disorders, narcolepsy, periodic limb movement disorder, and unusual movements and behaviors during sleep (parasomnias). Polysomnography is now commonly washed in the home to diagnose obstructive sleep apnea, just not whatever other sleep disorders.

A multiple slumber latency test is done to distinguish between concrete fatigue and excessive daytime sleepiness and to check for narcolepsy. People spend the day in a sleep laboratory. They are given the opportunity to take five naps at 2-hr intervals. They lie in a darkened room and are asked to take a nap. Polysomnography is used every bit part of this test to appraise how chop-chop people fall asleep. Information technology detects when people fall asleep and is used to monitor the stages of slumber during the naps and to make up one's mind whether REM (dreaming) sleep occurs. During multiple sleep latency testing, people with narcolepsy typically autumn asleep quickly and have at least two REM naps.

These tests involve monitoring and recording the activity of the encephalon, heart, breathing, muscles, and eyes. Various other body functions, including motility of the limbs, are also monitored and recorded.

Commonly, narcolepsy does non result from abnormalities that can be detected past brain imaging procedures, such as computed tomography (CT) or magnetic resonance imaging (MRI). However, doctors may use brain imaging and blood and urine tests to rule out other disorders that can crusade excessive daytime sleepiness.

• General measures

• Drugs that assist proceed people awake

There is no cure for narcolepsy. Still, for many people, continued treatment results in normal lives.

People should too effort to become enough slumber at night and take cursory naps (less than 30 minutes) at the same time every day (typically afternoon). If symptoms are mild, these measures may be all that is needed.

For others, drugs that help keep people awake, such as modafinil, armodafinil, solriamfetol, pitolisant, or sodium oxybate are used to help reduce the sleepiness. Doctors monitor people closely during drug treatment.

Dextroamphetamine and methylphenidate, which are stimulants, are used simply if other narcolepsy drugs are ineffective or cause intolerable problems. These drugs tin cause agitation, high blood pressure, a fast heart rate, and moodiness. They may also be habit-forming.

Modafinil, armodafinil, solriamfetol, and pitolisant work in a slightly different way from dextroamphetamine and methylphenidate, have fewer side furnishings, and are less likely to exist habit-forming. Thus, these four drugs are the preferred handling for people who have narcolepsy without cataplexy. Pregnant women should not accept modafinil because it may cause severe birth defects, including heart defects.

Sodium oxybate, a drug taken while in bed and over again during the dark, can ordinarily lessen excessive daytime sleepiness and cataplexy. Sodium oxybate is the preferred treatment for people with narcolepsy and cataplexy. Side effects include nausea, airsickness, dizziness, urinary incontinence (involuntary urination), sleepiness, and sometimes sleepwalking.

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Source: https://www.msdmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/sleep-disorders/narcolepsy

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